Mollen R M, Hopman W P, Kuijpers H H, Jansen J B
Department of Surgery, University Hospital Nijmegen, The Netherlands.
Eur J Gastroenterol Hepatol. 1999 Jul;11(7):701-8. doi: 10.1097/00042737-199907000-00003.
To further delineate motor activity of the upper gastrointestinal tract in patients with slow-transit constipation.
A prospective study comparing healthy volunteers with patients with a clinical diagnosis of slow-transit constipation.
Eighteen patients with clinical diagnosis of slow-transit constipation and 10 healthy controls were included in the study. Fasting antroduodenal motility was measured by perfusion manometry for at least one complete cycle of the migrating motor complex or a maximum of 300 min. Oesophageal manometry, gastric emptying and orocaecal transit time measurements were also performed.
At least one complete cycle of the migrating motor complex was observed in all controls, but in only nine patients (P < 0.01 versus control). The migrating motor complex cycle was incomplete (n = 5) or phase 3 activity was absent (n = 4) in the other patients. The incidence of clustered contractions was significantly increased in slow-transit constipation (P = 0.05 versus controls). The area under the contraction curve during late phase 2 (1509+/-296 mmHg x s) in patients with a complete cycle was significantly smaller than that in controls (2997+/-614 mmHg x s; P = 0.05). Orocaecal transit time was not significantly different among patients and controls, but oesophageal motility was abnormal in five of 18 patients and gastric emptying was abnormal in eight of 15 patients.
Abnormalities of upper gut motility occur frequently in patients with slow-transit constipation. Interdigestive antroduodenal motility is characterized by (i) absence or prolonged duration of the migrating motor complex, (ii) an increased number of clustered contractions, or (iii) a decreased motility during late phase 2 of the migrating motor complex.
进一步明确慢传输型便秘患者上消化道的运动活动情况。
一项前瞻性研究，比较健康志愿者与临床诊断为慢传输型便秘的患者。
本研究纳入了18例临床诊断为慢传输型便秘的患者和10名健康对照者。通过灌注测压法测量空腹时十二指肠的运动情况，记录至少一个完整的移行性运动复合波周期或最长300分钟。同时还进行了食管测压、胃排空和口盲肠转运时间的测量。
所有对照组均观察到至少一个完整的移行性运动复合波周期，但仅9例患者观察到（与对照组相比，P<0.01）。其他患者的移行性运动复合波周期不完整（n = 5）或无3期活动（n = 4）。慢传输型便秘患者成簇收缩的发生率显著增加（与对照组相比，P = 0.05）。有完整周期的患者在移行性运动复合波2期后期的收缩曲线下面积（1509±296 mmHg·s）显著小于对照组（2997±614 mmHg·s；P = 0.05）。患者和对照组之间的口盲肠转运时间无显著差异，但18例患者中有5例食管运动异常，15例患者中有8例胃排空异常。
慢传输型便秘患者上消化道运动异常较为常见。消化间期十二指肠运动的特点为：（i）移行性运动复合波缺失或持续时间延长；（ii）成簇收缩数量增加；（iii）移行性运动复合波2期后期运动减弱。
